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腰椎内镜减压治疗腰椎管狭窄症和退变性腰椎侧凸的临床及影像学结果:一项平均随访4.4年的回顾性研究

Clinical and radiological outcomes of lumbar endoscopic decompression for treating lumbar spinal stenosis and degenerative lumbar scoliosis: a retrospective study at mean 4.4 years follow-up.

作者信息

Fan Ning, Wang Aobo, Yuan Shuo, Du Peng, Wang Tianyi, Zang Lei

机构信息

Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

Front Surg. 2025 Jan 15;11:1525843. doi: 10.3389/fsurg.2024.1525843. eCollection 2024.

Abstract

PURPOSE

To assess the clinical and radiological outcomes of lumbar endoscopic decompression for the treatment of lumbar spinal stenosis (LSS) with concurrent degenerative lumbar scoliosis (DLS).

METHODS

This study retrospectively reviewed 97 patients with LSS and DLS who underwent lumbar endoscopic decompression between 2016 and 2021. The average follow-up duration was 52.9 months. Another 97 LSS patients without DLS were selected as the control group. The pre- and postoperative visual analog score (VAS) and the Oswestry disability index (ODI) were recorded and analyzed to compare clinical outcomes. Radiological findings, such as coronal balance and intervertebral disc height, have also been reported.

RESULTS

Both groups' mean VAS scores for back pain, leg pain, and ODI were significantly improved two weeks after surgery and at the final follow-up ( < 0.001). There was no significant difference in the prevalence of surgical complications or patient satisfaction rates. However, patients in the DLS group reported more severe back pain at the final follow-up than those in the LSS group ( = 0.039). Radiological follow-up revealed no significant deterioration in coronal imbalance or loss of disc height in either group.

CONCLUSION

Lumbar endoscopic decompression can be a safe and effective surgical technique for treating LSS with DLS, particularly in elderly patients with poor general conditions.

摘要

目的

评估腰椎内镜减压术治疗合并退变性腰椎侧凸(DLS)的腰椎管狭窄症(LSS)的临床和影像学结果。

方法

本研究回顾性分析了2016年至2021年间接受腰椎内镜减压术的97例LSS合并DLS患者。平均随访时间为52.9个月。另选97例无DLS的LSS患者作为对照组。记录并分析术前和术后的视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI),以比较临床结果。还报告了冠状面平衡和椎间盘高度等影像学结果。

结果

两组患者术后两周及末次随访时的背痛、腿痛平均VAS评分和ODI均显著改善(<0.001)。手术并发症发生率和患者满意率无显著差异。然而,DLS组患者在末次随访时的背痛比LSS组患者更严重(=0.039)。影像学随访显示两组患者的冠状面失衡或椎间盘高度丢失均无显著恶化。

结论

腰椎内镜减压术对于治疗合并DLS的LSS是一种安全有效的手术技术,尤其适用于一般状况较差的老年患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bfb/11774992/179a79014e51/fsurg-11-1525843-g001.jpg

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